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MIONI, ROBERTO (2008) Differenza Anioni Cationi e
Bilancio Idrogenionico nell’uomo
Nuovi concetti nello studio Clinico
dell’Equilibrio Acido – Base.
[Ph.D. thesis]

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Abstract (english)

Pathophysiological and clinical investigations on A/B turnover in man have been carried out in the light of the law of the Electroneutrality, the Anion - Cation difference theory that allows us to calculate the net amount of H+ ions actually donated to or removed from ionic solutions. The organ - specific removal of non - metabolizable, metabolizable and Carbonic acid(ity), on the part of the kidney, intermediate metabolism and the lung, respectively, has also been defined. From the general equation of net Titratable Acid (TA), as measured by the overall Cation - Anion difference, a series of equations have been derived, relevant to Endogenous Non - metabolizable (inorganic) Acid Production (NEAP) and its renal excretion. These equations allow us to conclude that: 1) the only net effective Titratable Acid production results from difference between endogenous H2SO4 generation and intestinal Alkali absorption, the latter being measured as inorganic Cation - Anion difference. 2) The renal Excretion of Net Acid (NEAE) is also given by the difference between the urinary SO42- and Base excretion, the latter being calculated as Cation - Anion difference, too. As a consequence, the whole body net Acid / Base balances (NAb(W) / NBb(W)) have been obtained from the difference between the intestinal Base absorption and urinary Base excretion, SO42- being disregarded, due to its zero balance.
According to Oh, these Acid / Base balances tend to zero. This demonstrates that the bodily Acid retention does not take place even with the western diets, whose acid loading exceeds 40 mEq/day.

Abstract (italian)

I dati chimico - clinici relativi allo studio dell'EAB nei soggetti normali o portatori di varie patologie, sono stati interpretati in accordo con i seguenti principi:
1) Legge dell'Elettroneutralità
2) Acidità Titolabile Netta in accordo con il principio operativo di Titolazione a pH 7.40.
3) Differenza Anioni - Cationi intesi come radicali Acidi / radicali Basici, per la misura reale del bilancio di H+ ioni.
4) Organo specificità degli emuntori nei riguardi degli Acidi / Basi non metabolizzabili (Rene), degli Acidi / Basi metabolizzabili (Metabolismo Intermedio), dell'Acido Carbonico / CO2 (Polmone).
5) Misura netta di Acidità / Basicità Titolabile ottenuta sempre dalla differenza Anioni - Cationi non metabolizzabili e Anioni - Cationi metabolizzabili.
L'applicazione alla ricerca clinica delle metodologie basate su questi principi ha portato alla conclusione:
a) che la produzione endogena di Acidità / Basicità netta deriva dal bilancio tra la produzione endogena di H2SO4 e l'assorbimento intestinale di Basicità netta, quest'ultima sotto forma di sali alcalini di acidi metabolizzabili e dell'acido carbonico (RCOONa; NaHCO3).
b) che l'escrezione urinaria di Acidità / Basicità netta è rappresentata ancora dalla differenza tra 2SO42- urinario e Cationi - Anioni non metabolizzabili escreti con le urine.
c) che infine il bilancio netto corporeo di Acidità / Basicità si calcola dalla sola differenza tra Base assorbita dall'intestino ed Base escreta con le urine, entrambe misurate dalla differenza Cationi - Anioni non metabolizzabili, escludendo l'anione SO42- e gli anioni organici (metabolizzabili).
I risultati ottenuti sono in armonia con le osservazioni di Oh ed escludono che nella maggior parte dei casi di IRC esista un bilancio Acido corporeo positivo.

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EPrint type:Ph.D. thesis
Tutor:D'ANGELO, ANGELA
Ph.D. course:Ciclo 21 > Scuole per il 21simo ciclo > SCIENZE MEDICHE, CLINICHE E SPERIMENTALI > SCIENZE NEFROLOGICHE
Data di deposito della tesi:28 January 2009
Anno di Pubblicazione:2008
Key Words:anioni, cationi, bilancio idrogenionico, equilibrio acido base, Legge Elettroneutralità
Settori scientifico-disciplinari MIUR:Area 06 - Scienze mediche > MED/14 Nefrologia
Struttura di riferimento:Dipartimenti > pre 2012 - Dipartimento di Scienze Mediche e Chirurgiche
Codice ID:1526
Depositato il:28 Jan 2009
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Bibliografia

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